title: Prognostic value of survivin expression in parotid gland cancer in consideration of different histological subtypes.
abstract: BACKGROUND
  Cancer of the major salivary glands comprises a morphological diverse group of rare tumours of largely unknown cause. Survivin, an inhibitor of apoptosis has shown to be a significant prognostic indicator in various human cancers. The aim of this study was to assess the long-term prognostic value of survivin in a large group of histological different salivary gland cancers.
  
  
  METHODS
  We analysed the survivin expression in 143 patients with parotid gland cancer by means of immunohistochemistry and tissue micro array. Survivin expression was categorised into a low and a high expressing group. The experimental findings were correlated with clinicopathological and survival parameters. The mean follow-up time was 54.8 months.
  
  
  RESULTS
  A positive cytoplasmic expression of survivin was found in 61.5%, a high expression in 25.9% of all specimens. In the whole group, high cytoplasmic survivin expression significantly indicated a poor 5-year disease-free and overall survival rate (p < 0.0001, p = 0.003). This applied for all adeno-, adenoid cystic and undifferentiated carcinomas whereas in mucoepidermoid carcinomas an analogical non-significant trend could be observed. A high cytoplasmic survivin expression significantly indicated a poor survival in high grade but not in low grade tumours. A multivariate analysis revealed that high cytoplasmic survivin expression was the only significant negative prognostic indicator for a poor 5-year disease-free survival rate in all patients (p = 0.042).
  
  
  CONCLUSIONS
  The correlation between cytoplasmic survivin expression and survival probabilities of salivary gland cancer might make this an effective tool in patient follow-up, prognosis and targeted therapy in future.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Cologne, Kerpener Strasse 62, 50937 Cologne, Germany. markus.stenner@uk-koeln.de
authors.forename: Markus
authors.initials: M
authors.lastname: Stenner
authors.forename: Ariane
authors.initials: A
authors.lastname: Demgensky
authors.forename: Christoph
authors.initials: C
authors.lastname: Molls
authors.forename: Aline
authors.initials: A
authors.lastname: Hardt
authors.forename: Jan C
authors.initials: JC
authors.lastname: Luers
authors.forename: Maria
authors.initials: M
authors.lastname: Grosheva
authors.forename: Christian U
authors.initials: CU
authors.lastname: Huebbers
authors.forename: Jens P
authors.initials: JP
authors.lastname: Klussmann
mesh_terms: D017209:Apoptosis; D003593:Cytoplasm / Q000378:metabolism; D018572:Disease-Free Survival; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D051034:Inhibitor of Apoptosis Proteins / Q000096:biosynthesis*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010307:Parotid Neoplasms / Q000175:diagnosis* / Q000378:metabolism*; D011379:Prognosis; D016016:Proportional Hazards Models; D012468:Salivary Gland Neoplasms / Q000175:diagnosis / Q000235:genetics; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D000077022:Survivin